Influencing factors and population attributable risk percent of low back pain in automobile assemblers / 中国职业医学

Objective: To investigate the influencing factors and population attributable risk percent (PAR%) of low back pain in automobile assemblers. Methods: A total of 634 assemblers from 11 automobile manufacturers in Shiyan City, Hubei Province were chosen as research subjects using judgment sampling method. The prevalence of low back pain in the past one year was investigated using Musculoskeletal Disorders Questionnaire. PAR% was used to analyze the contribution of influencing factors to low back pain. Results: The annual prevalence of low back pain was 68.8%. The results of multivariate logistics regression showed that length of service>15 years, high school or secondary college education or above, standing most of the time, sitting most of the time, the proportion of cumulative time of poor posture in work shift time ≥1/8, and bending for insufficient height of working space were the risk factors for low back pain (all P<0.05). The PAR% of the proportion of cumulative time of poor posture in work shift time ≥1/8 was 43.0%, 37.8% for standing most of the time, and 12.8% for bending for insufficient height of working space. Conclusion: The annual prevalence of low back pain was higher in automobile assemblers. The influencing factors included individual factors and occupational factors. The proportion of cumulative time of poor posture in work shift time ≥1/8, standing most of the time and bending for insufficient height of working space should be taken as the priority intervention factors to reduce the prevalence of low back pain among assemblers in this enterprise.

Influencing factors and attribution analysis of hand/wrist musculoskeletal disorders among welders in an automobile factory / 环境与职业医学

Background Welders in automobile manufacturers are prone to hand/wrist musculoskeletal disorders (MSDs), which seriously affect workers' physical and mental health. Objective To investigate the factors influencing hand/wrist MSDs of welders in an automobile factory and the population attributable risk percentage (PARP). Methods Five branches of an automobile factory were selected by convenient sampling method, and all qualified welders in the selected branches were enrolled as research participants. The Chinese Musculoskeletal Disorders Questionnaire was used to collect information such as general characteristics of welders, presentation of MSDs in the wrists and hands, and selected ergonomic factors. Log-binomial model in the SAS program was used to calculate the prevalence ratio (PR) of each influencing factor and PARP. Results The prevalence rate of MSDs in the hands/wrists of welders in the automobile factory was 44.1% (345/782). The results of multiple analysis showed that female (PR=1.25, 95%CI: 1.10-1.44), being very tired after work (versus not tired, PR=2.22, 95%CI: 1.16-4.25), twisting wrists (PR=1.44, 95%CI: 1.19-1.74), insufficient operating space (PR=1.22, 95%CI: 1.07-1.40), and holding or pinching objects by hands (PR=1.58, 95%CI: 1.18-2.12) increased the risk of reporting hand/wrist MSDs symptoms. The PARP of major occupational risk factors was: holding or pinching objects by hands, 32.46%; twisting wrists, 21.50%; being very tired after work, 15.28%; and insufficient operating space, 8.18%. Conclusion The prevalence of MSDs symptoms in hands/wrists of welders in this automobile factory is high. Gender, holding or pinching objects by hands, twisting wrists, being very tired after work, and insufficient operating space are the factors affecting hand/wrist MSDs, among which holding or pinching objects by hands and twisting wrists are the priority intervention factors.

Relationship between depression and anxiety with sleep quality in elderly adults / 中华老年医学杂志

Objective:To evaluate the influence of depression and anxiety on sleep quality, and to provide a basis for preventing sleep disorders in community-dwelling older adults.Methods:Cluster sampling was used.A self-designed questionnaire, the Pittsburgh Sleep Quality Index(PSQI), the Patient Health Questionnaire-9(PHQ-9), and the Generalized Anxiety Disorder Questionnaire-7(GAD-7)were used for the survey.The sleep quality and the influence of depression and anxiety on sleep quality of 955 community-dwelling older adults aged 60 and above were investigated.Results:The detection rate of sleep disorders, depression and anxiety were 24.5%, 19.1% and 14.3%, respectively.There was a positive correlation between sleep quality scores(including the total score and the scores of each dimension)and the anxiety and depression scores( rs: 0.115-0.558, P<0.01 for all). After adjusting for possible confounding effects of gender, age, food intake or tea drinking before bed, Logistic regression analysis showed that the presence of depression( OR=3.555, 95% CI: 2.235-5.653, P<0.05)and anxiety( OR=1.812, 95% CI: 1.070-3.070, P<0.05)were significantly related to sleep disorders in the elderly.The multivariate adjusted population attributable risk of depression and anxiety for sleep disorders in the elderly was 32.56% and 16.09%, respectively.The presence of depression and anxiety were associated with 38.87% of the population attributable risk for sleep disorders. Conclusions:Depression and anxiety are important risk factors for sleep disorders in the elderly.Strengthening the identification and intervention of depression and anxiety is beneficial to improve the sleep quality of elderly living in the community.

Burden of Cardiovascular diseases attributable to risk factors in Brazil: data from the "Global Burden of Disease 2019" study

Abstract INTRODUCTION: To better understand trends in the main cause of death in Brazil, we sought to analyze the burden of cardiovascular risk factors (RF) and cardiovascular diseases (CVD) attributable to specific RFs in Brazil from 1990 to 2019, using the estimates from the GBD 2019 study. METHODS: To estimate RF exposure, the Summary Exposure Value (SEV) was used, whereas for disease burden attributed to RF, mortality and disability-adjusted life-years (DALY) due to CVD were used. For comparisons over time and between states, we compared age-standardized rates. The sociodemographic index (SDI) was used as a marker of socioeconomic conditions. RESULTS: In 2019, 83% of CVD mortality in Brazil was attributable to RF. For SEV, there was a reduction in smoking and environmental RF, but an increase in metabolic RF. High systolic blood pressure and dietary risks continue to be the main RF for CVD mortality and DALY. While there was a decline in age-standardized mortality rates attributable to the evaluated RF, there was also a stability or increase in crude mortality rates, with the exception of smoking. It is important to highlight the increase in the risk of death attributable to a high body mass index. Regarding the analysis per state, SEVs and mortality attributable to RF were higher in those states with lower SDIs. CONCLUSIONS: Despite the reduction in CVD mortality and DALY rates attributable to RF, the stability or increase in crude rates attributable to metabolic RFs is worrisome, requiring investments and a renewal of health policies.

Políticas públicas latinoamericanas en la comunidad LGBTIQ (lesbianas, gays, bisexuales, trans, intersexuales, queer): revisión documental / Latin American Public Policies in the LGBTIQ (Lesbian, Gay, Bisexual, Trans, Intersex, Queer) Community: Documentary Review / Políticas públicas latino-americanas sobre a comunidade LGBTIQ (lésbicas, gays, bissexuais, trans, intersexual, queer): uma revisão documental

Históricamente, se ha evidenciado una vulneración de los derechos de la población LGBTIQ desde lo social, lo cultural, lo económico y lo laboral; sin embargo, poco a poco, ha empezado a participar política para la consecución de sus derechos y el recono-cimiento de estos. Objetivo: Identificar políticas públicas y legislaciones que cobijen a la comunidad LGBTIQ en países latinoamericanos como Argentina, Chile, Brasil, Colombia, Ecuador, El Salvador y México. Metodología: Revisión de literatura de tipo descriptiva, con documentos sobre políticas públicas en la población LGBTIQ. Se buscó en bases de datos como ProQuest, SciELO y Google Académico, en idioma español, en su gran mayoría por tratarse de políticas públicas latinoamericanas. Se obtuvieron sesenta documentos que cumplían con los criterios de inclusión y exclusión. Resultados: En países como Argentina, Ecuador y Colombia se reconoce la unión de hecho entre personas del mismo sexo, y en el caso de Argentina se da cabida al matrimonio. Con respecto a políticas contra la discriminación, están establecidas en países como Argentina, Brasil, Colombia y El Salvador; en cuanto a México, se prohíbe el matrimonio entre personas homosexuales. Conclusiones: Existen políticas públicas y los derechos que han adoptado en algunos países latinoamericanos para beneficiar a la comunidad LGBTIQ, para evitar que sigan siendo víctimas de violencia física, psicológica y social. Ello repercute en el gobier-no, el Estado y la organizaciones internacionales, que han creado las políticas públicas en su beneficio

Historically, the LGBTIQ population's social, cultural, economic and labor rights have been violated; however, social movements have gradually led to the political participation of this population for the achievement of their rights and their recognition. Objective: To identify public policies and legislation that cover the LGBTIQ community in Latin American countries such as Argentina, Chile, Brazil, Colombia, Ecuador, El Salvador and Mexico. Methodology: Descriptive literature review, with documents on public policies on the LGBTIQ population; the search was carried out in databases such as ProQuest, SciELO and Google Academic in Spanish language mostly because they deal with Latin American public policies; 60 documents were obtained that met the inclusion and exclusion criteria. Results: In countries such as Argentina, Ecuador and Colombia, de facto unions between persons of the same sex are recognized; in the case of Argentina, marriage is recognized. With respect to policies against discrimina-tion, they are established in countries such as Argentina, Brazil, Colombia and Salvador; as for Mexico, marriage between homosexual persons is prohibited. Conclusions: There are public policies and rights that have been adopted in some Latin American countries to benefit the LGBTIQ community, preventing them from continuing to be victims of physical, psychological and social violence impacting the government, the State and international organizations creating public policies for their benefit

114Volumen 8 • Número 1 • Enero - Junio 2021 • ISSN 2389-7325 • e-ISSN: 2539-2018Aura Katherine Gutiérrez-Díaz, Liset Carolina Fierro-Orozco, Ariadna María Angarita-NavarroPolíticas públicas latino-americanas sobre a comunidade LGBTIQ (lésbicas, gays, bissexuais, trans, intersexual, queer): uma revisão documentalRESUMOHistoricamente, os direitos da população LGBTIQ tem sido violados a nível social, cultural, econômica, e laboral; contudo, pouco a pouco, começaram a participar politicamente a fim de alcançar os seus direitos e o seu reconhecimento. Objetivo: Identificar políticas e legislações públicas que protejam a comunidade LGBTIQ em países da América Latina como Argentina, Chile, Brasil, Colômbia, Equador, El Salvador e México. Metodologia: Revisão de bibliografia de tipo descritiva, com documentos sobre políticas públicas relativas à população LGBTIQ. Bases de dados como ProQuest, SciELO e Google Acadêmico foram pes-quisadas, em idioma espanhol, a grande maioria delas por se tratar de políticas públicas latino-ameri-canas. Foram obtidos sessenta documentos que cumpriam os critérios de inclusão e exclusão. Resultados: Em países como Argentina, Equador e Colômbia, as uniões de fato entre pessoas do mesmo sexo são reconhecidas, e no caso da Argentina, o casamento é permitido. Em relação ás políti-cas contra a discriminação, estão em vigor em países como Argentina, Brasil, Colômbia e El Salvador; quanto ao México, o casamento entre pessoas do mesmo sexo é proibido. Conclusões: Existem políticas e direitos públicos que foram adoptados em alguns países da América Latina para beneficiar a comunidade LGBTIQ, para evitar que continuem a ser vitimas de violência física, psicológica e social. Isto tem um pacto no governo, no Estado e nas organizações internacio-nais, que criaram políticas públicas em seu benefício

A study on the risk and economic burden of common malignant tumor due to type 2 diabetes mellitus / 预防医学

Objective To evaluate risk and the direct economic burden of malignant tumor due to type 2 diabetes mellitus. Methods Combing the data of chronic disease surveillance, follow-up and the fifth health service investigation, we calculated the population attributable risk and the direct economic burden for malignant tumor due to type 2 diabetes mellitus in order to estimate the direct economic burden for tumor caused by type 2 diabetes mellitus. Results The relative risk was 1.68 (95%CI: 1.68-1.70) for people with type 2 diabetes mellitus to develop the malignant tumor than the people without type 2 diabetes mellitus. The proportions of attributable risk (AR%) and population attributable risk (PAR%) were 40.57% and 2.05%, respectively. Moreover, the annual average hospitalization costs for malignant tumor reached 11 billion CNY, which took part 6.48% of total health service costs. And the direct economic burden for malignant tumor due to type 2 diabetes mellitus was 0.228 billion CNY. In addition, the top two highest population attributable risks were colorectal cancer and liver cancer, while the top three greatest direct economic burdens for malignant tumor or malignant tumor due to type 2 diabetes mellitus were lung cancer, colorectal cancer and stomach cancer. Conclusion From this study, we found that type 2 diabetes mellitus increased the risks of tumor and therefore lead to sharply increasing in medical costs of malignant tumor. In order to decrease the risk of malignant tumor and medical costs, we should pay more attention to the prevention of type 2 diabetes mellitus and the screening of malignant tumor due to type 2 diabetes mellitus.

Identifying Target Risk Factors Using Population Attributable Risks of Ischemic Stroke by Age and Sex / 대한뇌졸중학회지

BACKGROUND AND PURPOSE: Estimating age- and sex-specific population attributable risks (PARs) of major risk factors for stroke may be a useful strategy to identify risk factors for targeting preventive strategies. METHODS: For this case-control matched study, consecutive patients aged 18-90 years and admitted to nine nationwide hospitals with acute ischemic stroke between December 2008 and June 2010, were enrolled as cases. Controls, individually matched by age and sex, were chosen from the 4th Korean National Health & Nutrition Examination Survey (2008-2010). Based on odds ratios and prevalence, standardized according to the age and sex structure of the Korean population, PARs of major risk factors were estimated according to age (young, or = 66 years) and sex subgroups. RESULTS: In 4,743 matched case-control sets, smoking (PAR, 45.1%) was the greatest contributing risk factor in young men, followed by hypertension (28.5%). In middle-aged men, the greatest contributing factors were smoking (37.4%), hypertension (22.7%), and diabetes (14.6%), whereas in women the greatest factors were hypertension (22.7%) and stroke history (10.6%). In the elderly, hypertension was the leading factor in men (23.7%) and women (23.4%). Other noticeable factors were stroke history (men, 19.7%; women, 17.3%) and diabetes (men, 12.5%; women, 15.1%). In young women, risk factors with a PAR greater than 10% were not found. CONCLUSIONS: Smoking cessation in young people and hypertension and diabetes control in older people may be effective in reducing the burden of stroke on the population. In the elderly, secondary prevention could also be emphasized.

Burden on blood-pressure-related diseases among the Chinese population,in 2010 / 中华流行病学杂志

Objective To quantify the burden of disease related to high blood pressure in the Chinese population. Methods We used results from the Global Burden of Diseases,Injuries,and Risk Factors Study 2010 (GBD 2010) in China. Data for mean systolic blood pressure,burden of deaths,Years of Life Lost(YLLs),Years Lived with Disability(YLDs),disability-adjusted life years (DALYs),and relative risk were corrected for regression dilution bias to calculate the population impact fractions and estimate the attributable deaths and DALYs. Results Among all the deaths due to cardiovascular diseases and DALYs,64.0%of them were caused by high blood pressure. In 2010,a total number of 2.043 million deaths were caused by high blood pressure,including 1.154 million males. 2.007 million deaths were due to cardiovascular diseases,35 000 due to chronic kidney diseases. Deaths caused by high blood pressure accounted for 24.6%of all the deaths. In total,37.94 million person-years DALYs were caused by high blood pressure,of which 23.33 million person-years were males and 14.61 million person-years were females. There were 2.365 million person-years of YLDs and 35.57 million person-years of YLLs,which both accounted for 12% of the total DALYs. Conclusion Compared to the global results of GBD 160,on either deaths or DALYs,the proportion attributable to high blood pressure were quite high for a country like China. The health effects caused by high blood pressure seemed to be quite serious which called for attention.

Burden on blood-pressure-related diseases among the Chinese population,in 2010 / 中华流行病学杂志

Objective To quantify the burden of disease related to high blood pressure in the Chinese population. Methods We used results from the Global Burden of Diseases,Injuries,and Risk Factors Study 2010 (GBD 2010) in China. Data for mean systolic blood pressure,burden of deaths,Years of Life Lost(YLLs),Years Lived with Disability(YLDs),disability-adjusted life years (DALYs),and relative risk were corrected for regression dilution bias to calculate the population impact fractions and estimate the attributable deaths and DALYs. Results Among all the deaths due to cardiovascular diseases and DALYs,64.0%of them were caused by high blood pressure. In 2010,a total number of 2.043 million deaths were caused by high blood pressure,including 1.154 million males. 2.007 million deaths were due to cardiovascular diseases,35 000 due to chronic kidney diseases. Deaths caused by high blood pressure accounted for 24.6%of all the deaths. In total,37.94 million person-years DALYs were caused by high blood pressure,of which 23.33 million person-years were males and 14.61 million person-years were females. There were 2.365 million person-years of YLDs and 35.57 million person-years of YLLs,which both accounted for 12% of the total DALYs. Conclusion Compared to the global results of GBD 160,on either deaths or DALYs,the proportion attributable to high blood pressure were quite high for a country like China. The health effects caused by high blood pressure seemed to be quite serious which called for attention.

Influence of chronic diseases on health related quality of life in middle-aged and elderly people from rural communities: application of EQ-5D scale on a Health Survey in Fangshan, Beijing / 中华流行病学杂志

Objective To evaluate the health related quality of life (HRQoL) and to explore the influencing factors related to the prevalence of the essential hypertension,diabetes,coronary heart disease (CHD) and stroke in middle-aged and elderly people from rural communities.Methods A total of 5345 individuals were chosen from a 2010 Health Survey in Fangshan,Beijing.Self-designed questionnaire was applied to collect the information on general health-related behaviors,chronic conditions,self-rated health,blood pressure and HRQoL with the EuroQoL questionnaire (EQ-5D) were measured.Probit regression model was used to identify the influencing factors on HRQoL,adjusting age,marriage status,education level,smoking,alcohol intake,physical activity and control of blood pressure.Population Attributable Risk Proportion (PARP) for estimating the influence of chronic disease on HRQoL was also calculated.Results The average EQ-5D index was 0.923 ±0.145,with 72.1％ of the overall respondents in the status of having chronic diseases.Participants with chronic diseases had significantly lower EQ-5D index (0.907 ± 0.155 ) than those without (0.963 ±0.105 ) (t =15.082,P＜ 0.001 ).Significant relations were found between a lower HRQoL and chronic diseases.Relative risk (RR) and 95％ confidence interval (95％ CI) of poor HRQoL in populations with hypertension,diabetes,CHD and stroke were 1.686 (95％CI: 1.519-1.871),1.725 (95％CI:1.502-1.981 ),1.869 (95％CI: 1.663-2.099),and 1.759 (95％CI: 1.474-2.089) respectively.The most influential disease appeared to be stroke in male (RR=1.929,95％CI: 1.462-2.546),whereas CHD in female individuals (RR=1.926,95％CI: 1.671-2.220).Rates of PARP (PAR％) for poor HRQoL in chronic disease subgroups were as follow: hypertension 31.05％,CHD 23.39％,diabetes 4.84％ and stroke 4.44％,respectively.Conclusion This study suggested that stroke,at individual level,was the major influential factor to HRQoL.However,hypertension remained the leading preventable influential factor to HRQoL at the population level.

Estimation of Attributable Burden due to Premature Death from Smoking in Korea / 예방의학회지

OBJECTIVE: In this study, we focused on estimating the burden of premature death in Korea caused by smoking using the YLL (years of life lost due to premature death) measurement. METHODS: First, we determined parameters: such as age-specific standard life expectancy, age on death, sex, and cause of death by analyzing the national death certificate data and life table collected during 1997. These were provided by the National Statistical Office. Secondly, we estimated the age group- specific years of life lost due to premature death by employing the standard expected years of life lost (SEYLL) measurement. Thirdly, the burden of premature death caused by smoking was estimated using the YLLs measurement which was developed by the global burden of disease study group. Fourthly, We calculated the risk related to smoking using the population attributable risk. RESULTS: The following results were obtained in this study:1) Premature death that is attributable to smoking in males could be prevented in 60.9% (513,582 person-year) by non-smoking.2) The burden of premature death by smoking for female was prevented to 17.7% (513,582 person-year) by non-smoking. CONCLUSION: We found that the YLL method employed in this study was appropriate in quantifying the burden of premature death. This provides a rational basis for planning a national health policy regarding premature deaths caused by smoking and other related risk factors.

a study on The Effect of The Tobacco Price Raise on The Smoking Rate and Smoking Attributable Death / 예방의학회지

This study was performed to estimate the quantity of the effects of tobacco price raise on the smoking rate, and the smoking attributable deaths in Korea. The data were collected by questionnaire survey from 538 male office workers. The questionnaire contained items on age, sex, living place, status of education, smoking history, the intention to quit smoking when the tobacco price be raised. The questionnaire were distributed to the offices of enterprises, hospitals, research centers, and public agencies and then collected. Data were analyzed by using the age specific smoking rate, relative risks of eight major smoking related diseases, vital statistics, and the population attributable risk of deaths of smoking males. On the other hand, the impact of the tobacco price raise on the population attributable risk of death due to smoking in Korea was estimated by applying the presumed smoking rate after the price raise. The results obtained were as follows: 1. The smoking rate of male white color workers in large cities was 59.5%. 2. The proportion of male smokers who has the intention to quit smoking when the tobacco price be raised was 61.5%. 3. The proportion of male smokers who has the intention to quit smoking if the price of tobacco be raised was proportional to the degree of increasing tobacco price. It is estimated that if the tobacco price were raised more than four times as now, the presumed smoking rate goes down as low as 26.7%. If the tobacco price be raised 20% each year, presumed smoking rate is 46.2%. 4. The number of attributable male death of smoking estimated by using 8 major smoking related diseases(lung cancer, laryngeal cancer, esophageal cancer, stomach cancer, pancreatic cancer, cerebrovascular disease, ischemic heart disease, chronic obstructive pulmonary disease) was 25,863 death each year. That is 20.1% of total age over 20 male deaths. 5. If the tobacco price were raised more than four times as now and all smokers who has intention to quit smoking quits smoking, 12,336 lives, or 47.7% of smoking related deaths could be saved. 6. If the actual practice rate of quitting smoking among male smokers with intention to stop smoking when the price of tobacco be raised is 10%, 25%, or 50%, then the expected decrease of death numbers when the tobacco price were raised more than four times as now can be 1,112, 3,483, 5,796 respectively.